On September 23, 2024, the United States Department of Justice (DOJ) announced significant updates to its principles regarding the prosecution and settlement of federal cases involving business organizations. These updates highlight the importance of corporate compliance programs in determining whether to pursue criminal charges for corporate misconduct.
The DOJ's revised framework, along with regulations from the Office of the Inspector General for the Department of Health and Human Services, is a valuable resource for healthcare providers involved with government programs like Medicare and Medicaid.
During her address at the 23rd Annual Society of Corporate Compliance and Ethics Institute, Principal Deputy Assistant Attorney General Nicole M. Argentieri discussed new focus areas, including the management of risks associated with disruptive technologies such as artificial intelligence. The DOJ now expects businesses to conduct thorough risk assessments when adopting new technologies and implement effective risk mitigation strategies.
Companies are also expected to monitor and test these strategies and adjust their compliance programs accordingly.
The updated guidance also emphasizes the importance of internal reporting of compliance concerns. The DOJ will evaluate whether businesses foster an environment that encourages employees to report suspected misconduct and whether they have policies in place to prevent retaliation against whistleblowers.
Access to data is another critical component of the DOJ's compliance evaluation. The agency will assess whether compliance operations have the necessary access to internal data to effectively monitor ongoing compliance efforts.
The DOJ will also evaluate whether compliance programs incorporate mechanisms to learn from both internal compliance issues and those reported by similar organizations. By integrating lessons learned from the broader industry, organizations can refine their compliance strategies and mitigate risks more effectively.
The DOJ has introduced pilot programs to incentivize compliant behavior among corporations and their employees. One such initiative requires businesses involved in DOJ settlements to assess employees' support for compliance-related activities as part of their incentive compensation decisions.
The DOJ has reported positive results from this initiative, indicating a positive shift in corporate compliance culture. The DOJ is also advocating for the inclusion of clawback provisions in compensation arrangements to hold individuals financially accountable for noncompliant behaviors.
The DOJ has confirmed the positive outcomes of its Corporate Whistleblowers Awards Pilot Program, which aims to enhance protections and incentives for whistleblowers in situations not covered by existing programs. The DOJ has identified healthcare schemes involving private insurers as a priority area for investigation.
As the DOJ continues to refine its compliance program guidance, healthcare providers and other businesses must adapt their compliance strategies to align with these evolving expectations. By fostering a culture of transparency, accountability, and proactive risk management, organizations can mitigate the risk of misconduct and enhance their overall operational integrity.
These updates signal a new era of corporate accountability that prioritizes compliance and ethical behavior in the business landscape.